Skills or Pills: Randomized Trial Comparing Hypnotherapy to Medical Treatment in Children With Functional Nausea.

Pamela D Browne, Clara M A de Bruijn, Esther M Speksnijder, Bibiche den Hollander, Herbert M van Wering, Margreet M S Wessels, Michael Groeneweg, Joery Goede, Carla Frankenhuis, Ellen Tromp, Marc A Benninga, Arine M Vlieger

Journal: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 2022;20(8):1847-1856.e6

PMID: 34718171

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Abstract

BACKGROUND & AIMS

The potential effectiveness of gut-directed hypnotherapy (HT) is unknown for pediatric chronic nausea. This randomized controlled trial compared HT with standard medical treatment (SMT).

METHODS

One hundred children (ages, 8-18 y) with chronic nausea and fulfilling functional nausea (FN) or functional dyspepsia (FD) criteria were allocated randomly (1:1) to HT or SMT, with a 3-month intervention period. Outcomes were assessed at baseline, at the halfway point, after treatment, and at the 6- and 12-month follow-up evaluation. Children scored nausea symptoms in a 7-day diary. The primary outcome was treatment success, defined as a reduction in nausea of 50% or more, at the 12-month follow-up evaluation. Secondary outcomes included adequate relief of nausea.

RESULTS

After treatment and at the 6-month follow-up evaluation, there was a trend toward higher treatment success in the HT group compared with the SMT group (45% vs 26%, P = .052; and 57% vs 40%, P = .099, respectively). At 12 months, treatment success was similar in both groups (60% in the HT group and 55% in the SMT group; P = .667). In the FN group, significantly higher success rates were found for HT, but no differences were found in patients with FD. Adequate relief was significantly higher in the HT group than in the SMT group at the 6-month follow-up evaluation (children: 81% vs 55%, P = .014; parents: 79% vs 53%; P = .016), but not at the 12-month follow-up evaluation.

CONCLUSIONS

HT and SMT were effective in reducing nausea symptoms in children with FN and FD. In children with FN, HT was more effective than SMT during and after the first 6 months of treatment. Therefore, HT and SMT, applied separately or in combination, should be offered to children with FN as a treatment option (Clinical trials registration number: NTR5814).

Address: Pediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Pediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: [email protected].; Department of Pediatrics, Amphia Ziekenhuis, Breda, The Netherlands.; Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands.; Department of Pediatrics, Maasstad Ziekenhuis, Rotterdam, The Netherlands.; Department of Pediatrics, Spaarne Gasthuis, Haarlem/Hoofddorp, The Netherlands.; Department of Statistics, Nieuwegein, The Netherlands.; Department of Pediatrics, St. Antonius Hospital, Nieuwegein, The Netherlands.

DOI: 10.1016/j.cgh.2021.10.029